[Long-term follow-up study of post-COVID-19 patients].

AIM: To evaluate dynamic changes in the lungs, hemostasis system, immune system in different terms after coronavirus pneumonia. MATERIALS AND METHODS: Ventilation-perfusion single-photon emission computed tomography/computed tomography (CT), functional methods of lung investigation, evaluation of hemostasis system, immune status and specific humoral immune response were performed and evaluated in different terms after coronavirus pneumonia. A total of 71 patients were examined according to this protocol. We examined patients with the lesion volume not less than 50% according to chest CT. All patients were divided into 2 groups depending on the distance from the acute stage of coronavirus pneumonia. Group 1 included patients who were examined early (3060 days after hospital discharge), group 2 included patients who were examined later (61180 days after hospital discharge). RESULTS: We obtained gradual regression of pathologically-modified tissue from 67.3% during the inpatient phase to 30.9% during the early period and to 19.7% during the late period of examination, according to CT scan of the chest organs. The same tendency was demonstrated by diffusion capacity of the lungs. Perfusion scintigraphy data showed a decrease in perfusion deficit from 26.012.8% during the early period of examination to 19.46.2% during the late period of examination. On the contrary, ventilatory scintigraphy demonstrates the increase of isotope passage time through the alveolar-capillary membrane over time (from 48.231.3 minutes in the early period to 83.637.2 minutes in the late period). An increase in D-dimer was detected in 24% of patients in the early group. The levels of inflammatory markers, indices of immune status, and specific humoral immune response did not differ in the two described groups. CONCLUSION: The results demonstrate gradual regression of pathological changes caused by coronavirus infection.

[Homeostasis changes during rehabilitation period after acute chemical poisoning].

The article deals with review of 78 patients of rehabilitation toxicological unit. The patients received resuscitation and detoxification. All patients were divided into three groups; 1st group--patients after poisoning with psychopharmaceuticals, 2nd group--patients after poisoning with cauterizing liquids and 3rd group--patients with encephalopathy after poisoning with neurotoxin (psychopharmaceuticals, narcotics and ethanol). Disorders of rheology, haemostasis and endotoxicosis accrued in all groups. These disorders were a signs of the erythrocytes and platelets aggregation developing and viscoelasticity disorder. Homeostasis changes during rehabilitation period need an accurate diagnostics for purposeful treatment of the defined disorders.

[Immunoprophylaxis of postoperative inflammatory complications in thoracic and abdominal wounds]. / Immunoprofilaktika posleoperatsionnykh gnoino-vospalitel'nykh oslozhnenii pri raneniiakh grudi i zhivota.

Immune system (IS) was studied in 228 wounded with penetrating knife and shotgun wounds of the thorax and abdomen complicated by hemorrhage more than 1000 ml. Six variants of IS reaction to trauma, hemorrhage, surgical stress and intensive therapy 1-2 days after surgery were registered. Comparative analysis of laboratory and clinical efficacy of prophylactic use of leukinferon in 99 patients (test group) was carried out. Control group consisted of 129 patients matched by gender, age, type of wound, hemorrhage volume and fluid therapy. High immunoprophylactic efficacy of leukinferon was demonstrated. Period of immunorehabilitation (normalization of leukogram, correction of immune imbalance) in patients of the test group was shortened twice. Purulent complications rate reduced from 24.9 to 1.0%, hospital stay--from 41.7 +/- 3.6 to 16.3 +/- 1.1 days.

[Evaluation of the effectiveness of immunomodulators in the treatment of patients with postoperative suppurative-septic complications]. / Otsenka éffektivnosti immunomoduliatorov pri lechenii bol'nykh s gnoino-septicheskimi posleoperatsionnymi oslozhneniiami.

The influence of immunoactive medicines on the cell immunity have been studied. There were differences in reaction to T-activin and Thymalin between various patients with septic postoperative complications. Thymalin stimulated T-cells while acting with immunoglobulins or immune plasmas only. T-activin led to the increase in the number of T-lymphocytes and B-lymphocytes independently of it's cooperation with the vaccines. The stimulating effect of myelopid demonstrated itself by increase in the number of B-lymphocytes and immunoglobulins M and G after 14 days of treatment. The positive clinical effect was more impressive when immunomodulators were used in combinations with the vaccines; still it did not correlate completely with the dynamics of the cell immunity parameters.